Study

Berberine and Adiposity in Diabetes-Free Individuals With Obesity and MASLD: A Randomized Clinical Trial (BRAVO)

Lubi Lei, Bin Wang, Lingshan Zhao, Jingkuo Li, Xiaofang Yan, Jiandong Jiang, Lulu Wang, Gang Ren, Yinchu Li, Xiaoguang Cheng, Xiaoyan Yan, Yidan Zhu, Yuanlin Guo, Hui Zhong, Haibo Zhang, Jing Li, BRAVO Collaborative Group

MULTICENTER, DOUBLE-BLIND, RANDOMIZED CLINICAL TRIAL (11 HOSPITALS IN CHINA) 2026

BRAVO: berberine 1 g/day for 6 months did not reduce visceral fat or liver fat, but lowered LDL-C and hsCRP.

Summary Does berberine reduce harmful body and liver fat in people with obesity? Show / hide ↓

Researchers gave 337 adults with obesity and MASLD, meaning fat buildup in the liver not caused by heavy alcohol use, either berberine or a placebo for six months. The study was randomized and blinded, so neither participants nor researchers knew who received berberine. Berberine did not clearly reduce visceral fat, the fat stored deep around internal organs, or liver fat. It did modestly lower LDL cholesterol, often called bad cholesterol, by about 8 mg/dL and slightly reduced a blood marker of inflammation.

What this means for you: This study does not support buying berberine to reduce body or liver fat at 1 gram daily for six months. It may have small effects on cholesterol and inflammation, but this was one study in a specific group and does not show better health outcomes.

moderate evidence

DesignMULTICENTER, DOUBLE-BLIND, RANDOMIZED CLINICAL TRIAL (11 HOSPITALS IN CHINA)

TierTier 1, Product RCT (peer-reviewed)

Year2026

JournalJAMA Network Open

N337

PublishedJan 2, 2026

Added to NO1GEVITYAug 15, 2026

BRAVO randomized 337 diabetes-free adults with obesity and MASLD to berberine 1 g/day or placebo for 6 months. Both primary endpoints were missed. Visceral adipose tissue area 1.4%, 97.5% CI −2.4 to 5.2. Liver fat content 0.9%, 97.5% CI −0.4 to 2.1. Secondary lipid outcomes moved. LDL-C −7.72 mg/dL, 95% CI −13.13 to −1.93. ApoB −3.42 mg/dL, 95% CI −6.33 to −0.51. hsCRP −0.072 mg/dL, 95% CI −0.140 to −0.004. The trial did not support berberine as an adiposity intervention at this dose and duration. It did support a modest lipid and inflammation effect.

Six months of berberine 1 g/day did not reduce visceral adipose tissue area or liver fat content in diabetes-free individuals with obesity and MASLD.

Critic notes

Marketing of berberine as ozempic-lite for weight loss is not supported by BRAVO. Any grade A rating for berberine on adiposity or weight loss should be revisited. Grade B or C fits the current evidence better.

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